Recurrent Twiddler's syndrome in a nonthoracotomy ICD system despite a Dacron pouch.
Twiddler's syndrome is a highly recognized yet rare complication of pacemaker and cardioverter defibrillator (i.c.d.) implantation. We present a case in which persistent generator rotation resulted in lead dislodgment and inappropriate shocks in an initial ICD and recurrent lead fracture in a second ICD system. This case is unusual in that even with extensive surgical precautions including use of a Dacron pouch, generator rotation could not be prevented. Submuscular implantation and use of a smaller generator may prevent Twiddler's syndrome.
Higgins
S L
SL
Regional Cardiac Arrhythmia Center, Scripps Memorial Hospital, La Jolla, CA 92037, USA.
Suh
B D
BD
Stein
J B
JB
Meyer
D B
DB
Jons
J
J
Willis
D
D
D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000523:psychology; D004868:Equipment Failure; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications; D011093:Polyethylene Terephthalates / Q000627:therapeutic use; D012008:Recurrence; D013577:Syndrome; D017180:Tachycardia, Ventricular / Q000628:therapy
D011093:Polyethylene Terephthalates